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General NPI Number Information
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NPI Number | 1285443374
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Entity Type | Individual
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Provider Name | MICHELLE SOMMERS LPC-IT
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Gender | Female
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 11516 N PORT WASHINGTON RD STE 208
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City | MEQUON
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State | WI
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Zip | 53092-3441
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Country | US
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Telephone | 262-518-0094
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Fax |
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Provider Business Mailing Address
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Address Line | 1685 HUNTERS LN
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City | GRAFTON
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State | WI
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Zip | 53024-9328
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Country | US
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Telephone | 414-640-1289
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8236-226
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License Number State | WI
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